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Purpose: The aim of this study is to obtain the anatomical limits of the parapharyngeal space by transoral surgical approach, in order to objectively determine the types of lesions according to location, where this type of approach is more indicated., Methods: A prospective, experimental, radio-anatomical study was performed on 10 cryopreserved human heads(20 sides). A transoral approach of the parapharyngeal space was performed determining its anatomical limits by CT navigation. A statistical analysis of the registered variables was carried out., Results: Intraoral endoscopic dissection of the parapharyngeal space was possible in all anatomical pieces (10 heads, 20 sides). The surgical technique was started by placing a laryngopharyngoscopic retractor. The scalpel incision was made from the posterior border of the hard palate, extending along the lateral border of the soft palate, following the glossopalatine arch and ending at the base of the tongue, in its posterolateral region. Under direct vision with a 0º rigid endoscope, we proceeded to the dissection by planes, identifying all the relevant vasculonervous, osseous and muscular structures. Once all the anatomical references were located, the planned measurements were taken using the surgical navigator., Conclusions: The endoscopic intraoral approach constitutes a feasible, safe and direct access route to the parapharyngeal space. This approach would be especially indicated in lesions of the parapharyngeal space (PPS) that do not exceed the styloid and pterygoid processes cranially, do not have significant retrostylial extension and do not substantially reach the lower area of the PPS., Competing Interests: Declarations. Ethical approval: This article does not contain any studies with animals performed by the author. All procedures performed in studies involving human participants were following the ethical standards of the institu- tional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Consent for publication: All authors consent to publication. Conflict of interest: All authors have no conflict of interests to declare., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Spontaneous cerebrospinal fluid (CSF) fistula, of unknown origin, is a rare condition whose aetiology is increasingly related to idiopathic intracranial hypertension (IIH). This study tries to raise awareness that they should not be considered as two different processes, but that fistulas can be a form of debut, requiring a study and subsequent treatment. Repair techniques are described, as well as the study of HII., Results: We treated 8 patients, 5 women and three men, aged between 46 and 72 years, with a diagnosis of spontaneous CSF fistula, four nasal and four otics who underwent surgical treatment. After repair, a diagnostic study was performed for IIH by MRI and Angio-MRI, presenting in all cases a transverse venous sinus stenosis. The intracranial pressure values obtained by lumbar puncture showed values of 20mm Hg or higher. All patients were diagnosed with HII. The one-year follow-up did not reveal any recurrence of the fistulas, maintaining a control of the HII., Conclusion: Despite their low frequency of both cranial CSF fistula and IIH, an association of both conditions should be considered by continuing the study and surveillance of these patients after fistula closure., (Copyright © 2023 Sociedad Española de Neurocirugía. Published by Elsevier España, S.L.U. All rights reserved.)

Archaeological research in the Dolmen of El Pendón (Reinoso, Burgos, Spain) has brought to light the complex biography of a megalithic monument used throughout the 4th millennium cal. BC. The ossuary of this burial holds the bones of nearly a hundred individuals who suffered from diverse pathologies and injuries. This study presents the discovery of a skull with two bilateral perforations on both mastoid bones. These evidences point to a mastoidectomy, a surgical procedure possibly performed to relieve the pain this prehistoric individual may have suffered as a result of otitis media and mastoiditis. The hypothesis of surgical intervention is also supported by the presence of cut marks at the anterior edge of the trepanation made in the left ear. Furthermore, the results of this paper demonstrate the survival of the individual to both interventions. Given the chronology of this dolmen, this find would be the earliest surgical ear intervention in the history of mankind., (© 2022. The Author(s).)

Objectives: To perform a radio-anatomical evaluation of the nasal cavity floor free mucosal graft (endonasal extended mucoplasty, EEM) to repair mucosal defects after an extended ethmoid-sphenoidotomy., Methods: A human cadaveric study (radiological and anatomical dissection) and an in vivo study in surgical patients with CRSwNP were performed. The EEM areas were compared between 3D reconstruction from CT scans and anatomical/surgical dissections, both in cadaver specimens and in patients. Feasibility was assessed by correlation between the EEM area on CT scans and when harvested in cadavers and when grafted in patients. Usefulness was assessed by the degree of coverage of the EEM in the surface exposed after an extended ethmoid-sphenoidotomy. Both feasibility and usefulness were assessed in cadaveric specimens (n = 15) and patients (n = 4)., Results: Fifteen cadaveric specimens and 4 patients with bilateral CRSwNP were included. The mean (SD) areas obtained in the cadaveric radiological and anatomical studies were 9.44 (2.07) cm 2 and 8.03 (1.36) cm 2 , respectively (intraclass correlation coefficient 0.59, moderate correlation), and in 3D reconstruction for operated patients were 10.32 (0.98) cm 2 and 11.27 (2.44) cm 2 , respectively. The coverage of the ethmoidal roof in the cadaveric dissection study was 100%, from the anterior ethmoidal artery to the posterior ethmoidal artery, covering the planun sphenoidale up to 75% in the case series. In 87.5% of the cases, up to 50% of the papiracea lamina was covered., Conclusion: The EEM have shown to be a feasible and useful grafting technique to repair skull base defects after performing an extended ethmoid-sphenoidotomy during surgery for CRSwNP., Level of Evidence: NA., Competing Interests: The authors declare no potential conflict of interest., (© 2020 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)

Isomeric tetraphenylbenzodifuran systems, benzo[1,2-b:5,4]difuran and benzo[1,2-b:4,5]difuran, containing electron acceptor groups (CF(3), CN, and NO(2)) have been synthesized and studied. Their electronic absorption, fluorescence, two-photon absorption cross sections, and electrochemical properties were investigated. The absorption and emission maxima are red-shifted for the linear-conjugated systems in comparison with the corresponding isomer. Dual fluorescence was observed and the existence of a twisted intramolecular charge transfer state was confirmed by low-temperature emission experiments. Wide HOMO-LUMO energy gaps were obtained ranging from 2.53 to 3.28 eV. HOMO levels were found in the energy range of -6.03 to -6.63 eV while LUMO are within -2.55 to -3.52 eV.

The presence of salivary tissue outside of the salivary glands, a term called "salivary heterotopia," is not very common. The co-existence of carcinoma expleomorphic adenoma in a salivary heterotopia in the upper third of the neck can be considered unusual. We present an infrequent and clinically unsuspected case of carcinoma expleomorphic adenoma in the upper third of the neck and independent of the salivary glands. The tumour developed within heterotopic salivary tissue, with the histopathological study of the surgical extract being decisive for its diagnosis. The cervical salivary embryogenesis of heterotopias and their oncogenesis is analyzed. Their clinical signs are reviewed to indicate the difficulty in distinguishing the different types of diagnosis from other primary or metastatic tumours so as to assist in choosing the therapy to follow.

Unlabelled: In order to evaluate possible trend changes in the epidemiological factors of adenotonsillar surgery, a total of 1,958 operations performed between 1992 and 2002 were reviewed., Results: One third of the operations were to remove tonsils in comparison with the two thirds that were to remove adenoids. Three procedures were used: 59% adenoidectomies, 28% adenotonsillectomies and 13% tonsillectomies. During the study period, the percentage of adenotonsillectomies decreased, whereas the number of adenoidectomies increased. In general, this kind of surgery is mainly performed on males., Conclusions: Although we have not discovered variations regarding gender and average age for the operations, adenotonsillar surgery has increased over recent years and the percentage ratio of the various procedures has altered as a result of new indications.

Report of one tracheocele case casually uncovered in a man 51-year-old. Starting from the difference between congenital and acquired cases of this pathology the AA. refer to the symptomatologic picture, to diagnostical and therapeutical measures as well, pinpointing to possible complications that may arise specially by infants during the lactation period.

We present one case of hereditary bisalbuminuria and bisalbuminemia in a Spanish family with three affected members. The double band of albumin was detected accidentally in an routine analytical study of a patient who showed hyperuricemia, this originated the study of the rest of the members of the family. Protein electrophoresis, in serum as well as in urine, showed a double band of albumin, which as in most published cases corresponded to the slow migration type. With immunoelectrophoresis its immune identity with common albumin was established. The biochemical parameters assessed did not show any alteration which could correlate the protein disorder with any associated pathology.